title: Evaluation of nutritional screening tools among patients scheduled for heart valve surgery.
abstract: OBJECTIVE
  The study aim was to detect the most sensitive nutritional screening tool and to assess its prognostic value with regards to an adverse clinical course in patients with heart valve disease undergoing cardiopulmonary bypass (CPB).
  
  
  METHODS
  This prospective cohort study included 441 adult patients who were screened using four nutritional screening tools: Nutritional Risk Screening 2002 (NRS-2002); Malnutrition Universal Screening Tool (MUST); Mini Nutritional Assessment (MNA); and Short Nutritional Assessment Questionnaire (SNAQ). Nutritional assessment was performed using a Subjective Global Assessment (SGA). In-hospital mortality, postoperative complications, and duration of hospital stay were each analyzed.
  
  
  RESULTS
  With regards to the detection of malnutrition, the sensitivities of MUST, SNAQ, MNA and NRS-2002 were 100%, 92%, 84.6% and 43.6%, respectively. Malnutrition identified by MUST and MNA were associated with postoperative complications (OR 1.63, p = 0.033 and OR 1.6, p = 0.035) and prolonged hospitalization (OR 1.57, p = 0.048 and OR 1.7, p = 0.02). According to multivariate logistic regression analysis, along with well-known age and duration of CPB, malnutrition identified by MUST and MNA was associated with a risk of development of complications (OR 1.6, p = 0.049 and OR 1.6, p = 0.04, respectively). The sensitivities of SNAQ, MUST, NRS-2002 and MNA with regards to postoperative complications were 26.8%, 28.8%, 10%, and 31.6%, respectively.
  
  
  CONCLUSIONS
  The MUST tool is preferable with regards to the detection of malnutrition. Both, MUST and MNA independently predicted postoperative complications. SNAQ and NRS-2002 proved insensitive with regards to the postoperative course among patients with heart valve disease who were scheduled for cardiothoracic surgery.
authors.affiliation: Department of Anesthesiology and Intensive Care, Research Institute of Circulation Pathology, Novosibirsk, Russian Federation.
authors.forename: Vladimir V
authors.initials: VV
authors.lastname: Lomivorotov
authors.forename: Sergey M
authors.initials: SM
authors.lastname: Efremov
authors.forename: Vladimir A
authors.initials: VA
authors.lastname: Boboshko
authors.forename: Dmitry A
authors.initials: DA
authors.lastname: Nikolaev
authors.forename: Pavel E
authors.initials: PE
authors.lastname: Vedernikov
authors.forename: Anna N
authors.initials: AN
authors.lastname: Shilova
authors.forename: Vladimir N
authors.initials: VN
authors.lastname: Lomivorotov
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Karaskov
mesh_terms: D000368:Aged; D002315:Cardiopulmonary Bypass; D015331:Cohort Studies; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000175:diagnosis*; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D015596:Nutrition Assessment; D011183:Postoperative Complications; D011300:Preoperative Care; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires